Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $109.65 / $109.65	Facility	26	$91.20	$109.65	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $354.81 / $537.03	Professional		$269.15	$354.81	$537.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $218.78 / $223.87 / $229.09	Facility	26	$218.78	$223.87	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $891.25 / $1,122.02	Professional		$794.33	$891.25	$1,122.02
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $549.54 / $1,513.56	Professional		$363.08	$549.54	$1,513.56
Hally Health Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $104.71 / $309.03	Professional	26	$91.20	$104.71	$309.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $338.84	Facility	26	$223.87	$223.87	$338.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $549.54 / $1,230.27	Professional		$380.19	$549.54	$1,230.27
Midlands Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $794.33 / $1,258.93	Professional		$645.65	$794.33	$1,258.93
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $158.49 / $275.42	Professional	26	$141.25	$158.49	$275.42
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $229.09 / $229.09 / $229.09	Facility	26	$229.09	$229.09	$229.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $870.96 / $870.96 / $977.24	Professional		$870.96	$870.96	$977.24
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $302.00 / $645.65	Professional		$75.86	$302.00	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $436.52 / $758.58	Professional		$371.54	$436.52	$758.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $537.03 / $676.08 / $794.33	Professional		$537.03	$676.08	$794.33